Endocrine Abstracts

A 35 year old woman was referred to Endocrinology after imaging investigating unexplained pyrexia demonstrated an absent uterus. She was of Pakistani origin and was born phenotypically female with reported normal female genitalia. During late teenage years she experienced virilisation with deepening voice, increased pubic and axillary hair and clitoromegaly. She had absent breast development. Her parents were first cousins and siblings were unaffected. Investigations in Pakist...

Background: There is much debate about the best imaging modality for parathyroid adenoma. Parathyroid ultrasound is operator dependent and in skilled hands leads to localisation of tumour. Small adenomas can be difficult to detect and radiologists are helped by clinical and biochemical data to predict ease of adenoma detection. We investigated whether any factors could predict adenoma size.Methodology: This was a retrospective CWS analysis of patients wh...

Imaging in paragangliomas can be challenging as they arise from a number of locations including the adrenals, abdomen, pelvic and thoracic sites of chromaffin sympathetic tissue. They can also arise in the head and neck at sites of parasympathetic tissue. They are considered within the group of heterogenous neuroendocrine tumours. In addition to manifesting at multiple sites, they can metastasise, have variable expression of catecholamines and can be a manifestation of heredit...

Objective: Biochemical assessment of male hypogonadism relies on estimation of freely available testosterone. Gold standard measurement is by equilibrium dialysis but this is not practical in clinical use. We compared two calculation methods; bioavailable (non-SHBG bound) testosterone (Morris et al.), and free (non-SHBG non-albumin bound) testosterone (Vermeulen et al.) for their diagnostic performance.Design: Free testosterone and bioa...

A 73-year-old independent female presented with reduced consciousness following a tonic-clonic seizure. Investigations revealed acute hyponatraemia, with a serum sodium of 103 mmol/l. Cortisol reserve and thyroid function was normal and the biochemical diagnosis was consistent with SiADH. A CT brain scan was normal. Hypertonic saline was commenced with empirical anti-viral and antibiotic therapy. Lumbar puncture revealed a slightly elevated CSF protein and her EEG showed non-s...

Succinate dehydrogenase subunit B (SDHB) mutations are associated with a high risk of developing pheochromocytomas, paragangliomas and renal cell tumours. The risk of malignancy is also higher than that of other SDH mutations.A 23-year-old woman was referred to endocrine clinic following confirmation of an SDHB mutation. Her family was screened when a relative underwent a medical, prior to starting a new job, and a significant family history of renal tum...

Objective: Identify predictors of pulsatile GH secretion following a triple secretagogue stimulus (TSS, Ghrelin and GHRH preceded by an infusion of Arginine) in a cohort of healthy postmenopausal women and healthy older men.Hypothesis: Even in older subjects, total GH secretory capacity is gender dependent.Design: 23 men and 19 women participated in 6 separate, overnight 16-h infusion sessions at Clinical Research Center. At the en...

Introduction: Significant hyponatraemia (serum sodium <128 mmol/l) is a potentially modifiable cause of prolonged hospital length of stay (LOS). By correcting euvolaemic hyponatraemia more rapidly than imposed fluid restriction, vasopressin receptor-2 antagonists may be useful adjuncts to existing treatments.Aim: To explore the potential clinical utility of vasopressin antagonists by describing the frequency and nature of hyponatraemia typically enco...

Case History: An 84-year-old women presented to a psychiatric unit with a 5-month history of fluctuating confusion, paranoid behaviour, anxiety, reduced cognition and unsteadiness. There was no history of galactorrhoea, headache or visual field disturbance. Past medical history included hypertension, chronic kidney disease, congestive heart failure, premature menopause and hyperlipidaemia. She had been taking bendroflumethiazide, furosemide, mirtazepine and sulpiride. A CT hea...

Case: A 73-year-old lady presented with hyponatraemia six days post-transphenoidal surgery for a non functioning pituitary macro-adenoma. Peri-operatively she developed diabetes insipidus requiring short term desmopressin whilst on the neurosurgical ward. At post-operative presentation she complained of weakness, confusion and nausea; sodium 125 mmol/l, serum osmolality 268 mOsmol/kg, urine osmolality 474 mOsmol/kg. Over the next few days she became symptomatically worse and h...